High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia.
10.3346/jkms.2012.27.12.1552
- Author:
Soon Min LEE
1
;
Ran NAMGUNG
;
Min Soo PARK
;
Ho Sun EUN
;
Kook In PARK
;
Chul LEE
Author Information
1. Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. Ranng@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Cholestasis;
Bronchopulmonary Dysplasia;
Risk Factors;
Rickets;
Infant, Extremely Low Birth Weight
- MeSH:
Alkaline Phosphatase/blood;
Birth Weight;
Bronchopulmonary Dysplasia/*etiology;
Case-Control Studies;
Cholestasis/*etiology;
Female;
Gestational Age;
Humans;
Incidence;
Infant;
Infant, Extremely Low Birth Weight;
Infant, Newborn;
Infant, Premature;
Male;
Parenteral Nutrition/*adverse effects;
Regression Analysis;
Retrospective Studies;
Rickets/enzymology/*epidemiology/radiography;
Risk Factors;
Severity of Illness Index
- From:Journal of Korean Medical Science
2012;27(12):1552-1555
- CountryRepublic of Korea
- Language:English
-
Abstract:
Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 +/- 16.1 days of age, and improved by 85.3 +/- 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.
